| NPI | 1316319874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 21727) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0004439) |
| 183500000X Pharmacist (Licence: PA rpi007619) | |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-10-23 |